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This study aims to estimate the effectiveness and cost-effectiveness of a) an internet based behavioural intervention with face-to-face nurse support as needed and b) an internet behavioural intervention with minimal nurse support and c) standard care among obese patients in primary care.

Background

The key principles adopted for development of the intervention were that it should:

be theory and evidence-based

be accessible and engaging

offer users who have become sceptical about the efficacy of diets a novel, empowering, self-management approach

have a positive, sustainable, focus on forming flexible healthy eating and physical activity habits rather than prescribing restrictive, complex, or intrusive regime

be fully integrated with the nurse support (for those receiving it)

take a graded approach to target-setting, ensuring the patient experiences early success in achieving goals.

Using the MRC-recommended approach to developing complex interventions, the key evidence-based elements and behaviour change techniques identified for inclusion were: goal-setting, planning and self-monitoring, techniques to enhance motivation and self-confidence, change self-defeating cognitions and create an environment that reduces cues to unhealthy eating and prompts and rewards healthy eating and physical activity, ‘success stories’ and evidence summaries that demonstrate how these techniques have been used by others to overcome barriers to weight loss; a discussion board with expert feedback from the nurse, and email and text reminders.